{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JOHN STEWART","gend":0,"add":"933 HILLVIEW BLVD","city":"VIRGINIA BEACH","state":"VA","zip":"23464-9998","dob":"1961-06-09","age":"","mstatus":"","insh":"20074075*01","cliId":"","pno":7576851020,"cno":7576851020,"email":"","ename":"","eno":"","pphy":"FRUCCI, JANICE B PA","ppno":7573186900,"pcpadd":"2017 PLEASURE HOUSE ROAD,","pcpcity":"VIRGINIA BEACH","pcpstate":"VA","pcpzip":"23455-9998","pcpcounty":"","pcpid":"","pcpname":"SMG - Sentara Family Medicine Physicians - Providence Road","plan":"OHP","program":"MEDICAID","lob":"OHCC","region":"TIDEWATER","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":7573186901,"pcpnpi":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S42.291A","Z00.00","I25.2","I10.","E11.9","E78.2","NO DATA","N40.1","F51.01","R35.1","I21.02","H91.93","M19.90","K21.9","I25.10","G47.33","F17.210","E78.5","M96.1","E55.9","G89.29","E83.110","Z53.29","Z98.1","I21.3","Z79.84","Z20.822","G47.30","R11.0","Z95.5","C67.9","R93.2","Z01.810","I25.118","Z01.818","M48.02","R13.19","R11.10","R13.12","Z12.5","Z72.0","R20.9","S00.03XA","S50.312A","Z01.812","M54.12","M54.5","Z23.","R63.4","K63.89","H90.5","H93.299","H93.13","R07.9","R94.31","R06.02","T50.901A","R53.83","R41.82","L30.0","Z71.9","F32.9","F17.200","Z13.220","Z13.29","Z12.11","D64.9","M54.9","Z79.891","Z87.891","I25.110","Z85.51","R68.2","R00.2","R13.10","J02.9","R53.1","Z68.1","Z91.198","J39.2","K63.9"],"date":["2022-06-14","2022-09-26","2023-03-27","2023-03-27","2023-03-27","2023-03-27","2022-09-26","2022-09-26","2022-09-26","2022-09-26","2022-01-18","2022-01-07","2022-01-07","2022-01-07","2022-06-02","2022-01-07","2023-05-28","2022-11-10","2022-01-07","2022-06-02","2022-06-04","2022-06-02","2022-01-07","2022-06-04","2022-01-08","2022-01-07","2022-01-07","2022-01-07","2022-05-16","2022-11-10","2023-05-04","2022-04-06","2022-11-28","2022-11-10","2022-11-28","2022-11-28","2023-04-17","2023-04-17","2023-06-01","2021-07-30","2022-01-18","2022-03-18","2022-06-04","2022-06-04","2022-11-28","2022-11-28","2021-08-05","2022-02-02","2023-05-28","2023-05-28","2021-03-12","2021-03-12","2021-03-12","2022-05-16","2022-01-07","2022-05-16","2022-12-07","2022-12-07","2022-12-07","2021-03-09","2021-03-09","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2023-06-28","2022-06-02","2022-06-04","2022-06-04","2022-06-04","2022-01-07","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-05-28","2023-06-28"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","31722059101","METOPROL SUC","TAB 100MG ER","90","Select","Select",""],["","43547035310","LISINOPRIL","10 MG","90","Select","Select",""],["","16729018201","HYDROCHLOROT","TAB 12.5MG","90","Select","Select",""],["","43598044774","NICOTINE TD","DIS 14MG\/24H","14","Select","Select",""],["","00536123441","ASPIRIN LOW","TAB 81MG EC","30","Select","Select",""],["","65862083030","PRASUGREL","TAB 10MG","90","Select","Select",""],["","00527143501","METAXALONE","800 MG","90","Select","Select",""],["","00766147020","NICODERM CQ","DIS 21MG\/24H","21","Select","Select",""],["","11822316910","RA ASPIRIN","TAB 81MG EC","30","Select","Select",""],["","70700010617","CLOBETASOL","OIN 0.0005","60","Select","Select",""],["","67877056105","METFORMIN","TAB 500MG","60","Select","Select",""],["","00093573301","OXYCODONE","TAB 40MG ER","60","Select","Select",""],["","69584011110","CARISOPRODOL","TAB 350MG","90","Select","Select",""],["","68180063809","ATORVASTATIN","TAB 80MG","90","Select","Select",""],["","65862059801","TAMSULOSIN","CAP 0.4MG","90","Select","Select",""],["","59011044010","OXYCONTIN","40 MG","20","Select","Select",""],["","65162037210","OXYBUTYNIN","TAB 10MG ER","30","Select","Select",""],["","11822316910","ASPIRIN EC","81 MG","30","Select","Select",""],["","72516003201","METOPROLOL SUCCINATE","100 MG","90","Select","Select",""],["","68180063809","ATORVASTATIN CALCIUM","80 MG","90","Select","Select",""],["","00406851501","OXYCODONE HCL","15 MG","90","Select","Select",""],["","00228282011","HYDROCHLOROTHIAZIDE","12.5 MG","90","Select","Select",""],["","67877056105","METFORMIN HCL","500 MG","180","Select","Select",""],["","65162037210","OXYBUTYNIN CHLORIDE ER","10 MG","90","Select","Select",""],["","00093573301","OXYCODONE HCL ER","40 MG","60","Select","Select",""],["","65862083030","PRASUGREL HCL","10 MG","90","Select","Select",""],["","16714071302","TAMSULOSIN HCL","0.4 MG","180","Select","Select",""],["","00093310953","AMOXICILLIN","500 MG","21","Select","Select",""],["","68180063809","ATORVASTATIN TAB","80MG","90","Select","Select",""],["","16729018201","HYDROCHLOROT TAB","12.5MG","90","Select","Select",""],["","65862083030","PRASUGREL TAB","10MG","90","Select","Select",""],["","43547035310","LISINOPRIL TAB","10MG","90","Select","Select",""],["","67877056105","METFORMIN TAB","500MG","180","Select","Select",""],["","00536123441","ASPIRIN LOW TAB","81MG EC","90","Select","Select",""],["","31722059101","METOPROL SUC TAB","100MG ER","90","Select","Select",""],["","11822316910","RA ASPIRIN TAB","81MG EC","30","Select","Select",""],["","00527143501","METAXALONE TAB","800MG","90","Select","Select",""],["","00135019403","NICODERM CQ DIS","21MG\/24H","21","Select","Select",""],["","00536589653","NICOTINE TD DIS","21MG\/24H","21","Select","Select",""],["","58657064501","CARISOPRODOL TAB","350MG","120","Select","Select",""],["","00406851501","OXYCODONE TAB","15MG","120","Select","Select",""],["","70700010617","CLOBETASOL OIN","0.05%","60","Select","Select",""],["","65862059801","TAMSULOSIN CAP","0.4MG","90","Select","Select",""],["","59011044010","OXYCONTIN TAB","40MG ER","60","Select","Select",""],["","65162037210","OXYBUTYNIN TAB","10MG ER","30","Select","Select",""],["","65649015090","RELISTOR","150 MG","90","Select","Select",""],["","43386009019","GAVILYTE-G","236-22.74G","4000","Select","Select",""],["","00254302902","LUBIPROSTONE","24MCG","60","Select","Select",""],["","55111064505","OMEPRAZOLE","40 MG","30","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}